See October 30 2023 CTV news : ” Quebec introduces new measures to cut down on psychiatric hospitalization ” These measures include Intensive Home Treatment programs
As I have mentioned in the past, compared to other countries, Canada has been extremely slow in developing Intensive Home Treatment programs , which are now available in eleven countries. So this is a really big deal
These IHT programs will be modelled on the program in Quebec city created in 2016 and featured in post 13 under category News on this website . That program was modelled on the British Crisis Resolution and Home Treatment ( CRHT) model mentioned in numerous posts on this website
Currently , in addition to Quebec City , there are two IHT programs in Montreal and five under development
The teams are made up of nine nurses, two social workers, an occupational therapist , an administrative assistant , a manager, and two psychiatrists for a full time equivalent
Case load 1-3 people per worker-20-25 patiens
Service arrangements as required may also be developed with the following : drug addiction worker, peer helper, family peer helper, hospital pharmacisrt
The plan is to eventually have an addiction trained person on the team
Working hours : 8am to 11 pm seven days a week
Nursing shift 8am to 4 pm; 4pm to 11 pm
Other professionals 8 am to 4pm
As yet I have no information about after hours care
Referral sources
Emergency rooms, psychiatry OP clinic, in patient wards
A centralized intake service which accepts all referrals from family doctors and directs them to the appropriate service
Teams will be required to adhere to the Crisis Resolution Home Treatment model .Fidelity to the model will be measured by the CORE Crisis Resolution Team Fidelity Scale ( post # 16 under resource tab and # 22 under research tab )and the Home Treatment Accreditation Scheme ( HTAS-) ( post # 13 and 15 under resource tab )
Total Staff Cost ( excluding psychiatrists ) $ 1.4 million per year
Home treatment
Duration 6-9 weeks
Initially , home ( or in the community ) visits twice daily. At least 50 % of patients seen twice a day during first 3 days. Frequency of contact is gradually reduced up to 2 times of week at the end of treatment
Patient and social supports can call the team at any time 8 am to 11 pm
Patient is seen at least once a week by the treating psychiatrist who visits their home as often as possible ; at least once during the course of the treatment